ICD-10 Code Set

WinOMS includes the ICD-10 diagnosis (Dx) code set, and provides new codes as they are updated annually. Annual ICD-10 code updates are installed to your database when you update to the new version.

Practice Preferences

The default ICD code version is set at the practice level.

To set the default ICD code set:

  1. Select Tables > Practice > Practice Preferences > Insurance.

  2. Under Miscellaneous > Default ICD Version, select ICD-10.

For more information, see Setting Up Default Insurance Information.

Patient Data Entry

Use the Extended tab of the Patient Data Entry window to enter up to four diagnosis codes for a patient.

For more information, see Adding Patient Information to the Extended Tab.

Plan Data Entry

The Diagnosis Method setting on the Forms/IDs/Notes tab of the Plan Data Entry window now has a third option for defining how diagnosis codes are displayed on claim forms for a particular plan. You can select 3 to include no diagnosis codes or pointers on the form.

For more information, see Adding Forms, IDs, and Notes.

Diagnosis Code Search window

The Diagnosis Code Search window has been updated to accommodate the ICD code set migration.

Diagnosis Code Data Entry

The Diagnosis Code Data Entry window has been updated to accommodate the ICD code set migration.

For more information, see Diagnosis Codes.

Diagnosis Code Selection

The Diagnosis Code Selection window has been updated to manage the use of old and new ICD codes. Diagnosis codes for any visit or claim must belong to the same code set version.

This window is displayed when you select Dx Codes or Edit Dx when creating or editing treatment plans or patient charges.

Charge Entry and Charge Edit

Up to 12 ICD codes are allowed on a single claim, with up to four codes per procedure. When the number of diagnosis codes exceeds 12, a second claim is created.

For more information, see Editing a Diagnosis on a Charge.

Treatment Plans and Authorizations

The total number of ICD codes allowed on a single claim is 12. When the total number of diagnosis codes exceeds 12, a second claim is created.

Treatment Plan Details

New windows enable you to view the diagnosis codes assigned to the procedures in a patient's treatment plan.

From the Treatment Plan tab of the Patient Workspace or Point-of-Care Encounter window, click the Details button. The View Treatment Plan Details window is displayed for the selected plan.

    • This window lists procedures and the associated Dx codes, regardless of whether they have been performed or converted to charges. It cannot be edited. To edit Dx codes for a procedure, return to the Treatment Plan window.

For more information, see Creating a Plan for Treatment Visits.

Claims and Dx Ordering

The new Claims Modification window enables you to adjust the order of diagnosis codes on a claim (box 21 for medical and box 34a for dental) after charges have been posted, before you submit the claim. The codes are labeled A through L, with A being the primary diagnosis.

The Dx Order is also displayed on the Claim Detail window accessed by clicking Details in the Insurance Processing Queue.

Previously, the Dx Order button was only available from the Charge Entry and Charge Edit windows at the time of posting.

To access the new Dx Ordering feature:

  1. From the Patient Workspace, select the Claims tab.

  2. Select a claim and click Edit. The Claims Modification window is displayed.

  3. Under Dx Rank, click and drag the codes to reorder them.

For more information, see Editing a Claim.